The effects of transcatheter aortic valve implantation on cardiac electrical properties

• Tipo: Artigo em Revista Científica Nacional
• Data: 2020

Autores

Manuel, AM (Autor) Outra; Almeida, J (Autor) Outra; Guerreiro, C (Autor) Outra; Dias, T (Autor) Outra; Barbosa, A (Autor) Outra; Teixeira, P (Autor) Outra; Ribeiro, J (Autor) Outra; Dias, A (Autor) Outra; Caeiro, D (Autor) Outra; Fonseca, M (Autor) Outra; Teixeira, M (Autor) Outra; Oliveira, M (Autor) Outra; Goncalves, H (Autor) Outra; Primo, J (Autor) Outra; Rodrigues, A (Autor) Outra; Gama, V (Autor) Outra; Braga, P (Autor) Outra; Fontes-Carvalho R (Autor) FMUP

Indexação

ISI Web of Knowledge - 5 Citações

Scopus - 5 Citações

Outras Informações

ID Authenticus: P-00S-K7X

DOI: 10.1016/j.repc.2020.02.011

Abstract (EN): Introduction: Transcatheter aortic valve implantation (TAVI) is associated with cardiac electrical disturbances. However, beyond the risks of pacemaker implantation, few studies have performed a detailed assessment of the effects of TAVI on several cardiac electrical properties. Objectives: To assess the frequency and type of electrocardiographic disturbances following TAVI, according to the type of prostheses and to assess predictors of these disturbances. Methods: We performed a detailed retrospective analysis of all electrocardiograms in patients who underwent TAVI, before and after the procedure, at a tertiary center from August 2007 to October 2016. Patients with permanent pacemakers were excluded. Results: We included 182 patients (78 +/- 8 years; 56% female) and self-expanding prostheses (SEP) were implanted in 54%. Most patients (80%) were in sinus rhythm at baseline. After TAVI, 21% of patients developed new-onset atrial fibrillation and there was a significant increase in PR interval at discharge (186 +/- 41 ms vs. 176 +/- 32; p=0.003), which was not maintained after at sixmonth follow-up (181 +/- 35 ms, p=0.06). There was also a significant increase in QRS duration at discharge (129 +/- 28 ms vs. 114 +/- 25 at baseline p<0.0001), which persisted at six-months (122 +/- 28 ms, p<0.0001). New-onset left-bundle branch block (LBBB) was observed in 25% of patients. The depth of valve implantation was a predictor of new LBBB at discharge after multivariate analysis (OR 37.6, 95% CI 14.6-65.2, p=0.001). Conclusions: The main electrocardiographic disturbances post TAVI were PR prolongation, increased QRS and new-onset LBBB. These disturbances were more pronounced in patients undergoing SEP implantation and tended to improve at six-month follow-up. The depth of valve implantation was a predictor of conduction disturbances. (C) 2020 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espana, S.L.U.

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 10